NFPA 1584: Not Just for Firefighters - @ JEMS.com


NFPA 1584: Not Just for Firefighters

 

 
 
 

W. Ann Maggiore, JD, NREMT-P | | Wednesday, September 10, 2008


Whether you work for a fire department or EMS agency, the new National Fire Protection Association (NFPA) standard for firefighter rehab affects you and your service. It outlines the responsibilities for EMS responders at fires by specifying the standards for rehabilitation of firefighters. The standard was put into place to affirm the importance of allowing firefighters adequate rest, hydration and caloric intake during hot, heavy work.

The new standard recognizes the leading cause of firefighter deaths: cardiac-related events. Almost half of the on-duty firefighter deaths are from heart attacks; almost twice the number of police officers who die on duty from cardiac events. The deaths tend to occur either during, or immediately after, incidents that require heavy work.

NFPA has looked at each of the three leading factors that contribute to firefighter deaths: underlying medical conditions, inadequate physical conditioning and heavy exertion. NFPA 1582 and 1583 look at the first two, while 1584 aims directly at on-scene heat exhaustion and inhalation injury.

According to NFPA, rehab should occur whenever on-scene activities pose the risk of members exceeding a safe level of physical or mental endurance. The types of incidents will vary from structural and wildland fires, hazmat incidents, multiple casualty incidents and any prolonged operation during bad weather. EMS is expected to take the lead in sharing the rehabilitation concept with law enforcement and other emergency services personnel who take part in the scene.

The new standard defines eight key objectives for rehab. These include relief from environmental conditions, rest and recovery, and active or passive cooling or warming as needed. They also include rehydration, calorie and electrolyte replacement, medical monitoring, member accountability and release for return to duty. Hot conditions will require shelter from the sun, hydration, prevention of burns from contacting hot asphalt and even sunscreen. Cold weather priorities may include shelter from wind and snow, increased caloric intake and a method for thawing gear, and frequent frostbite checks. The area devoted to rehab may be as simple as a single rescue or ambulance unit. It also may be as complex as a tent equipped with generators and communications equipment. Access to fresh water is essential, although many EMS agencies prefer sports drinks that provide electrolyte replacement. Think about basic needs, such as portable toilets, early on when facing incidents that will continue for some time.

Also required by the new standard is a minimum of BLS care and transport capability on a scene. EMS must keep records of which firefighters have rotated through rehabilitation, with an evaluation of vital signs including oxygen-saturation levels, and a thorough evaluation of injuries or complaints of illness. EMS medical directors should outline medical protocols that address when firefighters should be transported to a hospital. Vital signs parameters should be clearly outlined. Although there is still some discussion, 1584 outlines some basic vital signs parameters and mandates that EMS should examine anyone complaining of chest pain, dizziness, shortness of breath, weakness, nausea or headache, as well as muscle pain, changes in level of consciousness or mentation, and abnormal vital signs.

If a fire department doesn't have EMS, it's now required to develop mutual aid agreements with EMS agencies for provision of on-scene rehab. EMS is required to be trained and equipped to perform rehabilitation activities, and it must now outline a rehabilitation program that will be appropriate for the various types of fire incidents that occur under a constellation of environmental conditions. For example, although we always think of fire scenes as involving heat, firefighters can also become extremely cold when they exit a structural scene to find that the moist inside of their turnout gear has now frozen.

If your service currently doesn't have an EMS protocol for rehabilitation, it's time to start asking your service leaders and medical director to come into compliance. The standard is intended to help us take care of each other, so that we can continue to take care of everyone else.




Connect: Have a thought or feedback about this? Add your comment now
Related Topics: Legal and Ethical, Provider Wellness and Safety

 
What's Your Take? Comment Now ...

Buyer's Guide Featured Companies

Featured Careers & Jobs in EMS

Get JEMS in Your Inbox

 

Fire EMS Blogs


Blogger Browser

Today's Featured Posts

 

EMS Airway Clinic

Improving Survival from Cardiac Arrest Using ACD-CPR + ITD

Using active compression-decompression CPR with an ITD has been shown to improve 1-year survival from cardiac arrest by 33%.
More >

Multimedia Thumb

Philadelphia Fire Department Apologizes for Medic’s Jab at Police

Union head calls photos a slap in the face of officers.
Watch It >


Multimedia Thumb

D.C. Fire and EMS Crews Blame New Technology for Patient’s Death

Delayed response blamed on recurring dispatch problems.
Watch It >


Multimedia Thumb

Suspect Steals, Crashes Maryland Ambulance

One killed, others injured in Prince George’s County crash.
Watch It >


Multimedia Thumb

Truck Strikes Pedestrians in Scotland

Six killed in downtown Glasgow.
More >


Multimedia Thumb

Tennessee Trench Rescue

Worker pulled from Roane County worksite.
More >


Multimedia Thumb

Time’s Ebola Firefighters

Doctors, nurses and others saluted for fighting virus.
More >


Multimedia Thumb

VividTrac offered by Vivid Medical - EMS Today 2013

VividTrac, affordable high performance video intubation device.
Watch It >


Multimedia Thumb

LMA MAD Nasal™

Needle-free intranasal drug delivery.
Watch It >


Multimedia Thumb

The AmbuBus®, Bus Stretcher Conversion Kit - EMS Today 2013

AmbuBus®, Bus Stretcher all-hazards preparedness & response tool
Watch It >


Multimedia Thumb

Braun Ambulances' EZ Door Forward

Helps to create a safer ambulance module.
Watch It >


More Product Videos >